RESUMEN
Turner syndrome (TS; ORPHA 881) is a rare condition in which all or part of one X chromosome is absent from some or all cells. It affects approximately one in every 1/2500 liveborn girls. The most frequently observed karyotypes are 45,X (40-50%) and the 45,X/46,XX mosaic karyotype (15-25%). Karyotypes with an X isochromosome (45,X/46,isoXq or 45,X/46,isoXp), a Y chromosome, X ring chromosome or deletions of the X chromosome are less frequent. The objective of the French National Diagnosis and Care Protocol (PNDS; Protocole National de Diagnostic et de Soins) is to provide health professionals with information about the optimal management and care for patients, based on a critical literature review and multidisciplinary expert consensus. The PNDS, written by members of the French National Reference Center for Rare Growth and Developmental Endocrine disorders, is available from the French Health Authority website. Turner Syndrome is associated with several phenotypic conditions and a higher risk of comorbidity. The most frequently reported features are growth retardation with short adult stature and gonadal dysgenesis. TS may be associated with various congenital (heart and kidney) or acquired diseases (autoimmune thyroid disease, celiac disease, hearing loss, overweight/obesity, glucose intolerance/type 2 diabetes, dyslipidemia, cardiovascular complications and liver dysfunction). Most of the clinical traits of TS are due to the haploinsufficiency of various genes on the X chromosome, particularly those in the pseudoautosomal regions (PAR 1 and PAR 2), which normally escape the physiological process of X inactivation, although other regions may also be implicated. The management of patients with TS requires collaboration between several healthcare providers. The attending physician, in collaboration with the national care network, will ensure that the patient receives optimal care through regular follow-up and screening. The various elements of this PNDS are designed to provide such support.
Asunto(s)
Diabetes Mellitus Tipo 2 , Síndrome de Turner , Adulto , Cromosomas Humanos X/genética , Femenino , Humanos , Cariotipo , Cariotipificación , Síndrome de Turner/diagnóstico , Síndrome de Turner/genética , Síndrome de Turner/terapiaRESUMEN
Considering the patient's transition from child to adolescent to adult and its psychological aspects in endocrinology and diabetology, it is necessary to recall the child's psycho-affective development when he enters adolescence. Indeed, adolescence appears paradigmatic of the "child-adult" transition; it is a specific and decisive psychic process which allows the child to become an adult, that is to say autonomous and subject to his desire. In our paper, we study the resonance of a chronic disease in young people; type 1 diabetes is chosen.
Asunto(s)
Diabetes Mellitus Tipo 1/psicología , Diabetes Mellitus Tipo 1/terapia , Transición a la Atención de Adultos , Adolescente , Adulto , Niño , Enfermedad Crónica , Continuidad de la Atención al Paciente/organización & administración , Emociones , Femenino , Humanos , Masculino , Autonomía Personal , Psicología Infantil , Transición a la Atención de Adultos/organización & administración , Adulto JovenRESUMEN
The authors' clinical experience with young girls with Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH), who are facing the often hastily suggested, and accepted, surgical treatment of vaginal reconstruction brings new light to the question of female sexuality and its specific modes of access: its traumatic aspects, the mother-daughter conflict of ambivalence and the associated risk of depression, as well as the importance of the relational factor in the construction of bodily interiority.